23-728 New Address for Health Net Medi-Cal Provider Contested Claims
Date: 07/17/23
Be sure to use the correct address to submit additional information for contested claims
A contested claim is one for which Health Net, on behalf of CalViva Health, needs more information in order to process the claim. Participating providers can use the provider dispute resolution process to:
- Respond to a contested claim that the provider does not agree with that requires additional information.
- Inquire about the status of a claim or obtain payment calculation clarification.
- Resubmit contested claims with the missing information requested by Health Net.
- Submit a corrected claim (additional charges previously not submitted).
- Clarify member responsibility.
Provider must use the following address to submit or respond to contested claims:
CalViva Health Contested Claims Department
PO Box 989736
West Sacramento, CA 95798
Additional information
Relevant sections of the provider operations manuals have been revised to reflect the information contained in this update as applicable. Provider operations manuals are available electronically in the Provider Library on the provider portal > Provider Library under Quick Links, or go directly provider library.
Providers are encouraged to access the provider portal for real-time information, including eligibility verification, claims status, prior authorization status, plan summaries, and more.
If you have questions regarding the information contained in this update, contact CalViva Health at 888-893-1569.
This information applies to Physicians, Participating Physician Groups (PPGs), Hospitals, Ancillary providers, Community Supports (CS) Providers, and Enhanced Care Management (ECM) Providers.
This information applies to Medi-Cal in Fresno, Kings and Madera counties.